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ADVANCED DENTISTRY FOR YOUR PATIENTS AT BEVS

Our Dentistry department is led by Bill Kellner, DVM, DAVDC, a board-certified veterinary dentist with over 30 years of experience. We provide a full range of advanced oral care for companion animals in need, including:

  • Dental imaging
  • Endodontics
  • Feline dentistry
  • Maxillofacial surgery
  • Oral surgery
  • Orthodontics
  • Periodontal surgery
  • Senior, geriatric, and fragile pet dental/oral care – in addition to our advanced anesthesia training, we work closely with a board-certified anesthesiologist

VETERINARY ORAL SURGERY

Although our specialty college is named American Veterinary Dental College, a significant part of our training and practice area is in veterinary oral surgery. Diagnosing and operating oral tumors, and maxillary and mandibular fractures is a regular part of our practice. If you would like help with cases involving oral tumors or fractures, Dr. Kellner is here to help.


In addition to our significant training and experience, we often utilize CT for imaging and surgical piezotome, which has shown to be beneficial for many oral tumor excisions.

Common oral tumors treated in dogs are peripheral odontogenic fibromas, acanthomatous ameloblastomas, squamous cell carcinomas, malignant melanomas, and fibrosarcomas. In cats, squamous cell carcinomas and pyogenic granulomas are common.


Diagnostic evaluation typically includes a thorough oral exam under general anesthesia, intraoral radiographs, and CT scans of the head and generally the neck and chest to allow for full tumor staging, as well as tumor biopsy or excision and lymph node aspiration or excision.


For suspected malignant tumors, an initial incisional biopsy is typically performed, and then, guided by histopathology findings, definitive surgery is planned. Common surgeries include mandibulectomies and maxillectomies of various extents, utilizing surgical piezotome when indicated. The piezotome is often beneficial and can reduce complications and expedite healing.


Fracture management includes diagnostic intraoral radiographs and often head CT, followed by fracture stabilization, utilizing a variety of approaches, often including minimally invasive stabilization (wire-reinforced acrylic splints, modified labial buttons, and interfragmentary wire). Feeding tubes (esophagostomy) are placed as needed for nutrition management during fracture healing.

ORAL TUMOR CASES

Case Presentation #1: Lulu, 15-year-old Domestic Shorthair cat, presented with right caudal mandibular gingival and mucosal mass.

Diagnostics: Oral examination and intraoral radiographs—with findings highly suggestive of pyogenic granuloma—were performed.

Treatment: Excisional biopsy of the mass which confirmed the diagnosis, and extraction of the right maxillary third and fourth premolar, and molar. Pyogenic granulomas are commonly associated with subtle malocclusions and tooth extraction prevents recurrence.

Case Presentation #2: Dakota, 7-year-old female spayed Lab, presented with a tumor on the right palate-palatal to 108, 109; the primary care veterinarian performed an incisional biopsy.

Diagnosis: Oral Extramedullary Plasmacytoma.

Diagnostics: Oral examination, CT, and intraoral radiographs were performed.

Treatment: A right caudal maxillectomy was performed and clean margins were obtained. A cure is expected.

FRACTURE REPAIR CASES

Case Presentation #1: Lola, 5-year-old female Lab, presented with a right rostral mandibular fracture after being bitten by another dog in the home.

Diagnostics: Oral examination and intraoral radiographs were performed.

Treatment: Minimally invasive techniques were used - fracture reduction and a wire-reinforced acrylic splint was applied.

Fracture was reduced and wire was placed.

An acrylic splint was created, incorporating the wire reduction.

Case Presentation #2: Gunther, 1-year-old male German Shepherd, presented after being accidentally hit in the face with a bat.

Diagnostics: Oral examination and intraoral radiographs were performed.

Treatment: Minimally invasive Fracture Repair - fracture reduction and application of a wire-reinforced acrylic splint; this dog required a hemisection of 409 and vital pulp therapy of the distal root.

Mesial root of 409 was extracted and vital pulp therapy was performed to save the distal root, which plays an important role in the wire-reinforced acrylic splint stabilization.

Fracture reduction with splint in place, and Splint removal with excellent healing progress; distal root of 409 continues to be vital and did not require extraction.

Case Presentation #3: Fluffy, 5-year-old male neutered Domestic Long-Hair cat, presented with multiple bilateral mandibular fractures, trauma of unknown cause.

Diagnostics: Oral examination, CT, and intraoral radiographs were performed.

Treatment: Interfragmentary wire to stabilize the right mandibular ramus; esophagostomy feeding support tube placed; fractured mandibles placed into proper occlusion and jaws stabilized with modified labial button technique (MLB).

A different feline with MLB stabilization, to show the 3-button configuration.

If you would like to refer a patient to our Dentistry Department, please call us at 802.863.BEVS (2387). To help expedite the referral process, please fill out our Patient Referral Form online or visit our Referring Veterinary Portal. We look forward to working with you!

Burlington Emergency and Veterinary Specialists

1417 Marshall Avenue, Williston, VT 05495 | 802.863.2387 | bevsvt.com

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24/7 Emergency | Dentistry | Exotics | Internal Medicine

Neurology | Ophthalmology | Radioiodine (I-131) | Surgery

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